Businesses urged to take role in health care reform

Health care reform may be in a state of flux, and most major deadlines may be a year or more away, but experts warn that employers can not just sit around waiting to see what happens.

Maggie Moree, director of federal affairs for the Business Council of New York State Inc., told 250 employers at a recent Business Review Power Breakfast that those who choose not to plan for the future of health care “do so at their own peril.”

There are, of course, specific things to prepare for, including tax, reporting and enrollment changes contained in the reform act. But, the experts say, the business community’s responsibility does not end there. Those things will not bring down costs, the biggest health care problem for businesses, and employers cannot expect providers and insurers to solve the cost issue on their own.

“As business owners you are part of the solution,” said Dr. John Bennett, CEO of Capital District Physicians’ Health Plan. “You will solve this problem with us.”

Planning document

Moree said she looks at the health care reform act as a “planning document,” especially for businesses.

Among the things businesses need to prepare for is an extension of the 1.45 percent Medicaid tax, now on earned income, to passive income such as royalties and rent.

“That kicks in in 2013 but you can’t wait until then to do tax planning,” Moree said. “It’s too late.”

Businesses with more than 200 employees also need to be ready for automatic enrollment, which will take effect as soon as the government issues regulations. All workers will be put on the company health plan unless they opt out.

Then there are the upcoming changes in how health care costs are listed on employee W-2 forms. Starting in 2012, employers must list their costs alongside the worker’s.

Moree said this could be viewed as an opportunity, and suggested businesses adopt the change early.

“This is the least threatening way to start the conversation with your employees about health and what it really costs,” she said. “If you wait until the deadline you are putting off the conversation for almost two years, and in that time could be coming up with a solution together.”

Breaking the cycle

The experts say having this conversation with workers may be the biggest responsibility all employers, big and small, have right now.

“The bottom line is that health care costs are rising at an unsustainable rate,” said James Connolly, CEO of Ellis Medicine and a member of the panel. “It is not just per unit costs, it is consumption, our behaviors and the choices we make.”

He said most businesses respond to higher premiums by making purchasing decisions, but “the way to break this cycle is for all of us to engage in programs that encourage workers to be healthier.”

This may take many forms, from on-site gyms and wellness classes to benefits that reward healthier employees with lower cost sharing. The key is to engage workers and show them that their eating, exercise and other behaviors matter.

“This is a very hard thing to change,” said Dr. James Reed, CEO of Troy-based Northeast Health. “If it was easy, everyone would have done it a long time ago. But the fact that it is so hard to change probably means it would have significant impact if we did.”

It is easiest for large employers, who self-insure or are experience-rated, to see results from employee wellness. But even small companies in the community rating pool can play a part.

“We can work with a host of small groups and target the health of that whole population,” Bennett said.

A call to action

The panelists and other experts also encouraged businesses to make their voices heard.

“Businesses have been asleep at the wheel when it comes to things like mandates,” said David Oliker, CEO of MVP Health Care in Schenectady. “They need to get organized and politically active. Otherwise they will have to deal with what is out there.”

Bennett said employers should demand more transparency from hospitals and physicians.

“One of the things employer groups can do is come together and ask providers, in a very hard fashion, ‘what are we getting for our money?’ ” he said. “We have smart, tech-savvy, science-savvy employers in this region. This is a call to action for them to take a role in improving health care.”